Of all the back injuries, few are as misunderstood as disc lesions. In the low back, there are five bones (vertebrae) with five discs in between the bones. These discs are made up two primary components: the fibrous (collagen) outer ring called the annulus fibrosus, and the soft fluid filled center called the nucleus pulposus. Discs are often injured with excessive, sudden, and/or prolonged loading, causing the outer fibers to tear. These small tears act like most other tissue tears in the human body – they cause swelling, inflammation, bleeding and pain. In the early stages of disc injury, the pain is often felt in the back, hips and/or upper portion of the thighs.
Very important: INJURED DISCS HEAL. When discs tear, they heal over a period of time with the development of a scar, similar to that of a scar from a cut to the skin. Adequate blood supply is necessary to provide the disc with nutrition and oxygen, as well as to remove irritant substances. Movement, including spinal joint mobilization and exercise, improves blood supply. Discs work like a sponge – when compressed, they push fluid away from the center. When the pressure is released, fluid returns to the center of the disc and helps with nutrition.
If not properly treated, disc lesions may become a chronic source of problems. The tears tend to become more frequent and more serious with aging. Patients often describe more frequent episodes of back pain, increased intensity and, pain spread even further into the leg. When the tears become large, inflammatory chemicals escape from the disc and irritate the adjacent nerves. This can result in referred pain into a leg.
Physical therapy treatments are targeted to help the disc heal, strengthen muscles to avoid further episodes of back pain, and make appropriate lifestyle changes to prevent future occurrences.
Physical therapy treatments include the following:
- Exercise (core stabilization to train the trunk muscles to support the lower back, stretching/repeated movements to improve pain free range of motion, low intensity cardiovascular exercise to improve blood flow)
- Hands-on treatment (mobilization of the spinal joints to reduce stiffness/inflammation, soft tissue treatment to improve flexibility/reduce spasms, manual lumbar traction to reduce disc pressures)
- Activity Modification (posture education/correction to reduce disc pressures, proper lifting body mechanics to protect the discs, activity grading to reduce unneeded strain to the discs)
For more information and consultation, call Direct Physical Therapy at (541) 482-5525